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Related Experiment Videos

Behavioural treatment for chronic low-back pain.

R W J G Ostelo1, M W van Tulder, J W S Vlaeyen

  • 1Institute for Research in Extramural Medicine, VU University Medical Center, van der Boechorststraat 7, Amsterdam, Netherlands, 1081 BT. r.ostelo.emgo@med.vu.nl

The Cochrane Database of Systematic Reviews
|January 28, 2005
PubMed
Summary

Behavioral therapy, including respondent-cognitive and progressive relaxation, offers short-term pain relief for chronic low-back pain (CLBP) compared to waiting lists. However, long-term effectiveness and superiority over exercise therapy remain uncertain.

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Area of Science:

  • Rehabilitation Medicine
  • Behavioral Psychology
  • Pain Management

Background:

  • Behavioral treatment is a common approach for chronic low-back pain (CLBP), aiming to reduce disability by modifying environmental factors and cognitive processes.
  • Key behavioral treatment approaches include operant, cognitive, and respondent therapies.

Purpose of the Study:

  • To evaluate the effectiveness of behavioral therapy compared to reference treatments for CLBP.
  • To identify which specific types of behavioral treatment are most effective for CLBP.

Main Methods:

  • Systematic review of randomized trials identified through searches of CENTRAL, MEDLINE, EMBASE, and PsycLIT databases up to October 2003.
  • Inclusion criteria: randomized trials on behavioral treatment for non-specific CLBP.

Related Experiment Videos

  • Data extraction and quality assessment by two independent reviewers; pooled effect sizes calculated using random effects models for various outcomes.

    • Main Results:

    • Combined respondent-cognitive therapy and progressive relaxation showed significant short-term benefits for pain relief compared to waiting list control (WLC).
    • Operant treatment did not show significant differences from WLC for functional status or behavioral outcomes in the short term.
    • Limited evidence suggests graded activity programs may improve return to work and reduce sick leave; no significant differences were found between behavioral treatment and exercise therapy.

    Conclusions:

    • Respondent-cognitive therapy and progressive relaxation are effective for short-term pain relief in CLBP patients compared to WLC.
    • Long-term efficacy of these behavioral therapies is uncertain.
    • No significant differences in effectiveness were observed between behavioral treatment and exercise therapy for CLBP.